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Transzygomatic approach with anteriorly limited inferior temporal gyrectomy for large medial tentorial meningiomas
- Source :
- Acta Neurochirurgica. 157:1747-1756
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Tentorial meningiomas near the middle third of the medial tentorial edge with supratentorial extension are usually removed via the subtemporal approach. This approach, however, may not be practical, especially for huge tumors extending to the posterior subtemporal space. This study describes the use of the transzygomatic approach with anteriorly limited inferior temporal gyrectomy (TZ-AITG) to remove these large tumors. Between 2008 and 2012, five patients with symptomatic tentorial meningiomas (median diameter, 5.2 cm; range, 4.0–5.7 cm) near the middle third of the medial tentorial edge with supratentorial extension underwent TZ-AITG, consisting of zygomatic osteotomy, low-positioned craniotomy, and resection of the inferior temporal gyrus around 4 cm from the tip. Tumors were completely resected in all patients. Postoperatively, none had a newly developed neurological morbidity, and none died. Of three patients with preoperative hemianopia, two showed improvement and one remained stationary. One patient with preoperative hemiparesis recovered completely. All patients returned to their normal activities during the follow-up period. Surgical morbidities included epidural hematoma and chronic subdural hematoma in one patient each, with both requiring evacuation. TZ-AITG may be a good alternative to the subtemporal approach for large tentorial meningiomas near the middle third of the medial tentorial edge. TZ-AITG provides access to the lesions and visualization of the middle fossa, facilitating early feeder control while minimizing brain retraction, thus reducing potential injury to the vein of Labbe. TZ-AITG is also safe and feasible in minimizing neurological compromise.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Meningioma
Epidural hematoma
Inferior temporal gyrus
Meningeal Neoplasms
medicine
Humans
Craniotomy
Neuroradiology
medicine.diagnostic_test
business.industry
Interventional radiology
Middle Aged
medicine.disease
Psychosurgery
Surgery
Hemiparesis
Female
Neurology (clinical)
Neurosurgery
medicine.symptom
business
Subjects
Details
- ISSN :
- 09420940 and 00016268
- Volume :
- 157
- Database :
- OpenAIRE
- Journal :
- Acta Neurochirurgica
- Accession number :
- edsair.doi.dedup.....c21b5cb3ac19c72fb4d3157d8ef10a41